Manager, Case Management (RN)

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Lower Bucks Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Lower Bucks Hospital is a community hospital, serving the Lower Bucks County region with medical, surgical, and emergency care. Located in historic Bristol, Pennsylvania, the Hospital is well-known for its knowledgeable medical staff, including cardiology, orthopedics, radiology, wound care, and general surgery. The hospital has more than 200 physicians on staff, as well as another 700 employees.

The working Manager of Case Management is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program. Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators and utilization review technicians. Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs. Integrates and coordinates services using continuous quality improvement tools. Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

1. Licensed RN is PA.

2. Minimum 5 years’ experience in a Case Management position.

3. Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.

4. Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:

1. Certification in Case Management, BS or BSN or related field preferred.

2. Current BCLS certificate preferred.

3. Knowledge of Milliman Criteria and InterQual Criteria preferred.